Ross E. G. Upshur

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January 2007 | Volume 4 | Issue 1 | e50 On September 1, 2006, the World Health Organisation (WHO) announced that a deadly new strain of extensively drugresistant tuberculosis (XDR-TB) had been detected in Tugela Ferry (Figure 1), a rural town in the South African province of KwaZulu-Natal (KZN) [1], the epicentre of South Africa’s HIV/ AIDS epidemic. Of the(More)
Evidence-based decision-making is centred on the justification of decisions. In the shift from an individual-clinical to a population-policy level, the decision-making context becomes more uncertain, variable and complex. To address this we have developed a conceptual framework for evidence-based decision-making, focusing on how context impacts on what(More)
BACKGROUND In 2000, Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free influenza vaccines for the entire population aged 6 mo or older. Influenza immunization increased more rapidly in younger age groups in Ontario compared to other Canadian provinces, which all maintained targeted immunization programs. We(More)
The Bill & Melinda Gates Foundation (http: ⁄⁄www., the United States National Institutes of Health (http: ⁄⁄grants1.nih. gov/grants/index.cfm), the United Kingdom Wellcome Trust (http: ⁄⁄, and others are increasing funding for research on diseases that affect the world’s poor. The goal is to develop superior(More)
BACKGROUND Pregnant women are at increased risk of influenza-related complications, but research to examine barriers to maternal influenza vaccination has been limited and no studies have assessed the barriers to vaccinating pregnant women in Canada. OBJECTIVES The objectives of the study were to assess (1) how the knowledge, attitudes, and beliefs of(More)
BACKGROUND The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to(More)
1 Ethics Review Board, Médecins Sans Frontières, Geneva, Switzerland, 2 University of Toronto Joint Centre for Bioethics, Toronto, Ontario, Canada, 3 Unit of Epidemiology and Disease Control, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium, 4 Bioethics and Health Law Programme at the Center for the AIDS Programme of Research in(More)
Evidence-based approaches are assuming prominence in many health-care fields. The core ideas of evidence-based health care derive from clinical epidemiology and general internal medicine. The concept of evidence has yet to be analysed systematically; what counts as evidence may vary across disciplines. Furthermore, the contribution of the social sciences,(More)
BACKGROUND Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on(More)
Humanitarian agencies are increasingly engaged in research in conflict and post-conflict settings. This is justified by the need to improve the quality of assistance provided in these settings and to collect evidence of the highest standard to inform advocacy and policy change. The instability of conflict-affected areas, and the heightened vulnerability of(More)